title: Ileal or ileocecal resection for chronic radiation enteritis with small bowel obstruction: outcome and risk factors.
abstract: BACKGROUND
  The choice of the optimum surgical procedure for chronic radiation enteritis (CRE) has not reached a consensus over the years. This study aimed to evaluate the outcomes in patients undergoing ileal or ileocecal resection for CRE and to identify predictive risk factors for postoperative complications.
  
  
  METHODS
  Univariate and multivariate analyses of a retrospectively gathered database (2001 to 2011) were performed on a cohort of patients (N = 158) undergoing ileal or ileocecal resection for CRE obstruction at a single institution.
  
  
  RESULTS
  Overall and major morbidity rates were 57.0% (90 patients) and 28.5% (45 patients), respectively. Surgical complications occurred in 20 patients (12.7%) and postoperative permanent parenteral nutrition dependence was 12.1% (12 of 99 patients). Multivariate analysis determined that an American Association of Anesthesiologists' score of III or higher, anemia, low platelet level, intraoperative transfusion, presence of radiation uropathy, and experience of surgeons were independent risk factors for Clavien-Dindo grades III to V morbidity.
  
  
  CONCLUSIONS
  Ileal or ileocecal resection for CRE has an acceptable risk of permanent intestinal failure and surgical complications. This study also provides the 1st evidence of predictive risk factors for postoperative morbidity of ileal or ileocecal resection for CRE.
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, PR, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Weiming
authors.initials: W
authors.lastname: Zhu
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Gong
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.forename: Wenkui
authors.initials: W
authors.lastname: Yu
authors.forename: Qiyi
authors.initials: Q
authors.lastname: Chen
authors.forename: Ling
authors.initials: L
authors.lastname: Ni
authors.forename: Liang
authors.initials: L
authors.lastname: Zhang
authors.forename: Lili
authors.initials: L
authors.lastname: Gu
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications; D001803:Blood Transfusion; D002429:Cecal Diseases / Q000209:etiology / Q000601:surgery; D002432:Cecum / Q000601:surgery*; D002908:Chronic Disease; D002983:Clinical Competence; D003556:Cystitis / Q000209:etiology; D004751:Enteritis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology / Q000601:surgery; D007082:Ileum / Q000601:surgery*; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000532:radiotherapy; D010288:Parenteral Nutrition; D010976:Platelet Count; D011183:Postoperative Complications; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D014517:Ureteral Obstruction / Q000209:etiology; D055815:Young Adult
keywords: Intestinal failure; Intestinal resection; Postoperative complications; Radiation enteritis; Risk factors; Surgery